In 2016, a 70-year-old Nevada woman came home from India with a frightening stowaway: a persistent infection. After being admitted to the hospital, she was administered 14 different antibiotics, but unfortunately, none were effective and within two months she died of septic shock. Investigators from the Centers for Disease Control and Prevention (CDC) found that this “nightmare” bacterium was a CRE superbug, a strain of bacteria that has developed resistance to even the newest and most powerful class of antibiotics.
Antibiotics became a keystone of modern medicine when penicillin was introduced during World War II. Deadly conditions such as pneumonia could be treated effectively, and people with wounds small and large no longer risked blood poisoning from bacterial contamination. Antibiotics enabled the field of modern surgery to blossom and people started living longer.
But today, many of the microbes — microorganisms like bacteria — that cause common diseases and infections are evolving resistance to the drugs used to treat them. Scientists are now racing against the clock to find new ways to fight these drug-resistant superbugs with the CDC leading the charge.
The CDC’s Antimicrobial Resistance (AMR) Challenge is an initiative that encourages organizations around the world — including governments, businesses and NGOs — to make commitments to fight antimicrobial resistance and help develop the next generation of life-saving antibiotics. HP joined the AMR challenge this year with a CDC pilot program in four labs around the country that use HP’s D300e Digital Dispenser BioPrinters to “print” pharmaceutical samples and accelerate the testing of new antibiotics that can fight resistant bacteria. This program means the labs can give their local hospitals the capability to immediately determine if a bacteria is resistant or susceptible to a new antibiotic.
HP recently developed a way to adapt its inkjet printer technology for biomedical research. HP’s inkjet technology enables printers to drop tiny dots of ink from multiple nozzles at rapid speed to quickly deposit the ink on paper. That same technology can be used in labs.
“The printer dispenses tiny drops that are one thousand times smaller in volume than researchers can dispense by hand,” explains Erica Squires, applications scientist at HP. “It allows them to take these manual processes that use large volumes of liquid and miniaturize and automate them by having the dispensing done by the printer.”
The HP D300e Digital Dispenser provides a way to automate the dispensing of research compounds into test tube arrays, so scientists can study complex drug combinations more accurately, in a fraction of the time. (In addition to the CDC’s antibiotics research, the D300e works for a wide range of research applications, from cutting-edge cancer drug research to discovering new treatments for HIV.) The printers will help the CDC labs quickly and accurately test new antibiotics that show potential against these resistant infections, with the goal of getting the best new therapies to the people that need them as quickly as possible.
“The CDC performed a validation of our instrument to ensure it performs equivalently to previous methods that they’ve tested before,” says Squires. “They passed all of those validations with flying colors.”
Bacteria are living organisms, with the same propensity for adaptation that all living creatures have. And they quickly develop mechanisms that make them resistant to early antibiotic drugs. What follows is a biological arms race: Scientists develop new antibiotics as the older ones became less effective, and the cycle repeats as bacteria grow resistant to the new treatments. Ubiquitous use — and misuse — of antibiotics accelerate this process.
“Bacteria continuously develop new ways to resist antibiotics—once a drug is approved for use, the countdown begins until resistance emerges. In fact, resistance has even been detected before FDA approval,” says Jean Patel, PH.D. D (ABMM), Science Team Lead, Antibiotic Resistance Coordination and Strategy Unit, CDC. “To save lives and protect people, it is vital to make technology accessible to hospital labs nationwide.”
These efforts to detect drug-resistant bacteria and research into new pathogens and drugs help scientists sharing that information drive innovation. The CDC also collaborates with healthcare providers to help control antibiotic use and slow the rate at which bacteria develop resistance.
For Squires, part of her job is providing demos for scientists across the country. “When I do demonstrations, people get excited and start thinking through all the different processes that they can adapt to dispensing with inkjet technology,” she says. “The person using it puts whatever fluid they want in it, so we’re always working to expand the capability and make it work with all the different fluids our customers need to dispense.”
Today, we are nearing the end of the age of antibiotics as we know it. Some bacteria, like the case in Nevada, are already resistant to all known classes of antibiotics. Without a paradigm-shifting breakthrough, humanity could return to an era in which even minor surgeries pose a deadly risk of infection.
Antimicrobial and antibiotic resistance currently represents one of the greatest public health challenges of the modern era. “Antimicrobial resistance is projected to kill more people than cancer by 2050, and in the US we already see signs of pan-resistance hitting our shores.” Squires says. “So we’re honored that the CDC asked if we’d make a commitment to this global challenge.”